2010-11-01

Regulations Update

Marci Pederson, RN, BSN, Nurse Educator/Consultant

This month we take a break from Marci’s regular regulatory update to answer the following question from one of our readers:

Dear Ms. Pederson:

I write to you regarding the proper way to empty a male urinal. It may sound trivial but there is nothing I can find on the proper way to empty the urinal in a semi-private room and the toilet has no mechanism to facilitate their rinsing. I'd appreciate a moment of your time and will give credence to your opinion or policy.

Thank you, RN, BSN Clinical Resource Manager

Dear RN, BSN:

Thank you for your email and question. Before answering your question, I confirm that it is difficult to find something specific regarding what to do with emptying and cleaning a male urinal when the patient/resident is in a semi-private room. I did some searching on the CDC website and reviewed the federal regulations’ Guidance to Surveyors. Based on your description of the environment, I would make the following comments to answer your question.

Before handling a male urinal the health care worker (HCW) should don gloves because of the potential of touching the body fluid of urine.

With standard precautions we treat all body fluids as potentially infected.

The male urinal can be emptied into the toilet stool when there is a bathroom connected with the semi-private room.

Care should be taken not to spill or splatter drops of urine outside of the toilet bowl.

If that should happen, the spill must be wiped up immediately with the germicidal your facility uses according to the manufacturer’s recommendations and instructions.

The HCW should then place the urinal into a plastic opaque bag.

When the urinal is in the bag, the HCW may remove the gloves and wash hands with soap and water or alcohol-based hand-rub before touching anything else such as door handles.

The HCW can then carry the urinal enclosed in the bag to the soiled utility room.

Once the HCW has arrived at the soiled utility room and before taking the urinal out of the bag, the HCW should don gloves again.

The HCW then removes the urinal from the plastic bag, and rinses the urinal with the sprayer in the hopper.

After that the urinal can be sanitized with the facility’s disinfectant according to the manufacturer’s recommendations.

Most EPA-registered disinfectants have a label contact time of 10 minutes.

However, multiple scientific studies have demonstrated the efficacy of disinfectants against pathogens with a contact time of at least 1 minute.

The best practice is to follow the manufacturer’s instructions and recommendations.

Another thing to consider is the urinal manufacturer’s recommendations for cleaning the urinal.

Once the cleaning process is completed, the HCW should remove the gloves, clean the hands, and place the urinal in a clean plastic bag.

The HCW carries the urinal back to the patient/resident’s room and stores appropriately.

Sometimes urinals are seen on the over-bed table or night stand which also holds the water pitcher, telephone, and paper handkerchiefs.

It is preferable to store the urinal out of sight in the bottom part of the night stand.

However, some patients/residents will be very firm about where they want to store the urinal for easy access.

When this situation presents itself, the HCW needs to educate the patient/resident about the reason not to store the urinal in the same area as the drinking water.

If a compromise cannot be achieved, documentation is needed to describe the education provided to the resident and rationale for doing what is being done.

This information needs to be in the care plan.

Document the education, patient/resident response, and plan of action with date, time, and signature of the person documenting this.

Contact me at mapederson@avera.org for all of your Regulatory Compliance and Survey Preparation needs.

Do the math! The facility bottom line improves when resident care continually improves.

As a former health facilities senior surveyor, Marci worked at the Department of Health Office of Licensure and Certification for eight years. Marci provides Survey Preparedness Consulting designed to create a culture of constant survey preparedness by helping staff understand regulatory requirements, not just comply with them.